CAPT Celissa Stephens, Director Division of Nursing Services

1. PHS Nurse-Professional Advisory Council Lunch & Learn Indian Health Service Crosswalk Federal PHS Nurse Strategic Plan CAPT Celissa Stephens, Director Division of Nursing Services CAPT Carolyn Aoyama, Sr. Women’s Health Consultant CAPT Tina Tah, Sr. Public Health Nurse Consultant

2. INDIAN HEALTH SERVICE The Mission in partnership with American Indian and Alaska Native people, is to raise their physical, mental, social and spiritual health to the highest level. The Goal is to ensure that comprehensive, culturally acceptable personal and public health services are available and accessible to all American Indian and Alaska Native people. The Foundation is to uphold the federal government’s obligation to promote healthy American Indian and Alaska Native people, communities and cultures, and to honor and protect the inherent sovereign rights of Tribes.

3. Quick Look INDIAN HEALTH SERVICE • Provides a comprehensive health service delivery system for approximately 2 million American Indians and Alaska Natives. • Serves members of 566 federally recognized Tribes. • Indian Health Service total staff consists of about 15,930 employees, which includes approximately 2,640 nurses, 820 physicians, 670 pharmacists, 640 engineers/sanitarians, 340 physician assistants/nurse practitioners, and 310 dentists. • Approximately 70% of IHS staff are American Indians and Alaska Natives.

4. The People we Serve

5. Lunch & Learn Objectives 1) List 3 health disparities that impact American Indian/Alaska Native (AI/AN) members and communities. 2) The learner will be able to identify the IHS GPRA Measures that relate to HHS Goal. 3) The learner will be able to describe how the IHS nursing workforce contributes to improve the wellness of AI/AN members.

6. 2012 National Dashboard (IHS/Tribal) - Final

7. Goal 1: HEART HEALTHY Goal 2: HEALTHY EATING Obesity Trends • Among American Indian and Alaska Native (AI/AN) children and youth (ages 2-19), 45-51 percent are not at a healthy weight • 45 percent of children ages 2-5 are overweight or obese • 49 percent of children ages 6-11 are overweight or obese • Over 80 percent of AI/AN adults (ages 20-74) are overweight or obese • 85 percent of adults ages 45-54 are overweight or obese • AI/AN youth ages 10-19 years are 9 times likely to have diagnosed type 2 diabetes compared to non-Hispanic whites • There has been a 110 percent increase in diagnosed diabetes from 1990-2009 in AI/AN youth aged 15-19 years (IHS Clinical Reporting System 2009)

8. Goal 1: HEART HEALTHY • Improve cardiovascular health through prevention, detection and education… • GPRA CVD Comprehensive Assessment (screened for LDL, BP, BMI, tobacco use, nutrition counseling, exercise education); • Million Hearts – Controlling High Blood Pressure Measure • Let’s Move Campaign • Baby Friendly Hospitals

9. GOAL 2: HEALTHY EATING • Improve overall healthy eating and reduce obesity throughout the lifespan through early prevention, detection, and education. • GPRA Breastfeeding Measure – baseline in 2013 • GPRA Ideal Glycemic Control • GPRA CVD Comprehensive Assessment • Exploring breastfeeding peer counselor role for CHR • Baby Friendly Initiative – 3 hospitals with a potential 4th • IHS Policy supporting staff who wish to pump at worksite • Strengthening the Family Circle • IHS Healthy Beverages Kit; Physical Activity Kit (PAK) • Healthy Weight for Life • Let’s Move Campaign

10. GOAL 3: MENTAL & EMOTIONAL WELL BEING • Improve the mental health resilience and emotional well-being… • Depression Screening • Suicide surveillance • Methamphetamine and Suicide Prevention Initiative • Domestic Violence / Sexual Assault Prevention Initiative • Implementation of Sexual Assault Nurse Examiner Programs • Integration of BH services into primary care

11. GOAL 2: HEALTHY EATINGGOAL 3: MENTAL & EMOTIONAL WELL BEING • Program Goal: • Increase breastfeeding among American Indian/Alaska Native moms. • Process: • Increase awareness of the benefits of breastfeeding to mom and baby. • BFHI is part of the Let’s Move! in Indian Country initiative, • the First Lady Michelle Obama’s Let’s Move! initiative. • Brings together federal agencies, communities, nonprofits, corporate partners, and tribes with the goal of ending the epidemic of childhood obesity in Indian Country within a generation. • BFHI Goal: • Breast feeding has been shown to reduce childhood obesity. • IHS committed to helping all 13 IHS hospitals that provide maternity services to become Baby Friendly. In addition, IHS will encourage Tribal obstetrics facilities to make similar policy changes and achieve Baby Friendly Hospital status.

12. Baby Friendly USA Designation Process

13. The Good News Is: 2011 By Dec 2013 ZUNI BROWNING GALLUP CROWNPOINT HOPI WHITERIVER SHIPROCK ROSEBUDPIMC PINERIDGECLAREMORE BELCOURT CHINLE 13

14. GOAL 4: TOBACCO FREE LIVING • Enhance comprehensive and evidence-based efforts to prevent, reduce and eliminate tobacco use. • GPRA Tobacco Cessation Measure • GPRA CVD Comprehensive Assessment • Prescription of nicotine products to assist patient tobacco cessation efforts • No smoking in IHS hospitals, clinics, offices

15. GOAL 5: Advocate for FPHSN Strategic Plan • Civil Service nurses in IHS • PHS Nurse Officers in IHS • PHS Nurse Officers in Tribal employ • IHS nurses have been instrumental in National initiatives such as: • Baby Friendly Hospital Initiative • Partnership for Patients • Tobacco Cessation • SANE

16. FREE CEUAmerican Indian Public Health Disparities: Regional Differences in Health Target Audience: Physicians, Nurses, Health Educators and other Public Health Staff working in Local Health Departments and Primary Care Settings Objectives: After watching this broadcast participants will be able to: • Describe American Indian (AI) Health Policy • Identify AI Health Resource disparities • Describe key health disparities and regional differences • Discuss social determinants of health • List policy and program strategies to reduce disparities http://www.albany.edu/sph/cphce/phl_0213.shtml

17. Questions